Connecticut’s mortality rate from firearms is less than half the national average, the state’s homicide rate is slightly above half the national average, but the rate of drug poisoning deaths exceeds the national average.

Data from the Centers for Disease Control and Prevention (CDC) indicate that Connecticut’s mortality rate from drug poisoning was 17.6 per 100,000 population, with 623 deaths in the state in 2014, the 19th highest rate in the nation. The U.S. rate that year was 14.7, with 47,055 fatalities. Last year, Connecticut’s mortality rate from drug poisoning climbed to 22.1, which was the 11th highest rate in the nation, with 800 deaths.

The states with the highest drug poisoning mortality rates in the nation in 2015 were West Virginia, New Hampshire, Kentucky, Ohio, Rhode Island, Pennsylvania, Massachusetts, New Mexico, Utah, Tennessee and Connecticut. The lowest rates were in Nebraska, South Dakota, North Dakota, Texas and Iowa.

The CDC reported this month that opioids—prescription and illicit—are the main driver of drug overdose deaths. Opioids were involved in 33,091 deaths in 2015, and opioid overdoses have quadrupled since 1999.

In 2015, according to the CDC, significant increases in drug overdose death rates from 2014 to 2015 were primarily seen in the Northeast and South Census Regions. States with statistically significant increases in drug overdose death rates from 2014 to 2015 included Connecticut, Florida, Illinois, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Tennessee, Washington, and West Virginia.

The five states with the highest rates of death due to drug overdose were West Virginia (41.5 per 100,000), New Hampshire (34.3 per 100,000), Kentucky (29.9 per 100,000), Ohio (29.9 per 100,000), and Rhode Island (28.2 per 100,000).

The increase in drug overdose deaths in Connecticut from 2014 to 2015 was 25.2 percent, the fourth highest in the nation among states that had a statistically significant increase. Only Massachusetts, New Hampshire and Maine had larger increases.

Among the 28 states meeting inclusion criteria for state-level analyses, 16 (57.1%) experienced increases in death rates involving synthetic opioids other than methadone, and 11 (39.3%) experienced increases in heroin death rates from 2014 to 2015, the CDC reported.

The largest absolute rate change in deaths from synthetic opioids other than methadone occurred in Massachusetts, New Hampshire, Ohio, Rhode Island and West Virginia. The largest percentage increases in rates occurred in New York (135.7%), Connecticut (125.9%) and Illinois (120%).

Connecticut, Massachusetts, Ohio, and West Virginia experienced the largest absolute rate changes in heroin deaths, while the largest percentage increases in rates occurred in South Carolina (57.1%), North Carolina (46.4%), and Tennessee (43.5).

Connecticut announced a detailed opiate response initiative this fall. The Connecticut Opioid REsponse Initiative (CORE) is a strategic plan from Yale experts in response to the state’s opioid and overdose epidemics. It recommends: 1) expanding access to effective, medication-based treatment for substance use disorders; 2) improving transitions within the treatment domain; 3) increasing the availability of naloxone — the antidote to reverse an opioid overdose — and; 4) decreasing the over-prescribing of opioid at high doses or in combination with sedatives.

The CDC said “there is an urgent need for a multifaceted, collaborative public health and law enforcement approach to the opioid epidemic;” the Drug Enforcement Administration referred to prescription drugs, heroin, and fentanyl as the most significant drug-related threats to the United States, the CDC reported.